title: Effect of thermode application pressure on thermal threshold detection.
abstract: Studies using quantitative sensory testing (QST) often present incongruent results due to intra- and intersubject as well as interobserver variability which limit widespread use of the technique. Eliminating or reducing the factors responsible for this variability is of great interest, as it increases reliability and reproducibility of QST. Thermal sensory threshold determination is a crucial part of QST. It was previously suggested that the pressure of the thermode on the skin could influence measurements. To verify this, we developed a new thermode with a built-in pressure sensor. Thresholds obtained with this thermode were compared to those obtained with a commercially available thermotesting device (Medoc TSA-II). Heat detection and heat pain detection thresholds were higher, and cold detection thresholds were lower when measured with our thermode than they were with the Medoc thermode. Cold pain detection thresholds did not differ between the thermodes. Analysis of the heat transfer capacity of the thermodes indicated that the material of the skin contact surface of the thermode may play a role in these shifts in threshold values. Altering the thermode pressure on the skin did not affect the thermal thresholds. Furthermore, the intrasubject variability of the measurements (minimal-to-maximal range of measured threshold values in individual subjects) was also not influenced by the pressure with which the thermode was attached to the skin. Our results suggest that the pressure with which the thermode is attached to the skin does not significantly affect the intra- and intersubject reproducibility of the thermal sensory threshold measurements.
authors.affiliation: Center for Anesthesiology, Emergency and Intensive Care Medicine, University Clinic Göttingen, Robert-Koch-Strasse 40, D-37099 Göttingen, Germany.|University Children's Hospital, Department of General Pediatrics, University Clinic Göttingen, Göttingen, Germany.|Department of Medical Statistics, Georg-August-University Göttingen, Göttingen, Germany.|Department of Clinical Neurophysiology, University Clinic Göttingen, Göttingen, Germany.
authors.forename: Goran
authors.initials: G
authors.lastname: Pavlaković
authors.affiliation: Center for Anesthesiology, Emergency and Intensive Care Medicine, University Clinic Göttingen, Robert-Koch-Strasse 40, D-37099 Göttingen, Germany.|University Children's Hospital, Department of General Pediatrics, University Clinic Göttingen, Göttingen, Germany.|Department of Medical Statistics, Georg-August-University Göttingen, Göttingen, Germany.|Department of Clinical Neurophysiology, University Clinic Göttingen, Göttingen, Germany.
authors.forename: Ina
authors.initials: I
authors.lastname: Klinke
authors.affiliation: University Children's Hospital, Department of General Pediatrics, University Clinic Göttingen, Göttingen, Germany.
authors.forename: Helena
authors.initials: H
authors.lastname: Pavlaković
authors.affiliation: Center for Anesthesiology, Emergency and Intensive Care Medicine, University Clinic Göttingen, Robert-Koch-Strasse 40, D-37099 Göttingen, Germany.|University Children's Hospital, Department of General Pediatrics, University Clinic Göttingen, Göttingen, Germany.|Department of Medical Statistics, Georg-August-University Göttingen, Göttingen, Germany.|Department of Clinical Neurophysiology, University Clinic Göttingen, Göttingen, Germany.
authors.forename: Klaus
authors.initials: K
authors.lastname: Züchner
authors.affiliation: Department of Medical Statistics, Georg-August-University Göttingen, Göttingen, Germany.
authors.forename: Antonia
authors.initials: A
authors.lastname: Zapf
authors.affiliation: Department of Clinical Neurophysiology, University Clinic Göttingen, Göttingen, Germany.
authors.forename: Cornelius G
authors.initials: CG
authors.lastname: Bachmann
authors.affiliation: Center for Anesthesiology, Emergency and Intensive Care Medicine, University Clinic Göttingen, Robert-Koch-Strasse 40, D-37099 Göttingen, Germany.|University Children's Hospital, Department of General Pediatrics, University Clinic Göttingen, Göttingen, Germany.|Department of Medical Statistics, Georg-August-University Göttingen, Göttingen, Germany.|Department of Clinical Neurophysiology, University Clinic Göttingen, Göttingen, Germany.
authors.forename: Bernard M
authors.initials: BM
authors.lastname: Graf
authors.affiliation: Center for Anesthesiology, Emergency and Intensive Care Medicine, University Clinic Göttingen, Robert-Koch-Strasse 40, D-37099 Göttingen, Germany.|University Children's Hospital, Department of General Pediatrics, University Clinic Göttingen, Göttingen, Germany.|Department of Medical Statistics, Georg-August-University Göttingen, Göttingen, Germany.|Department of Clinical Neurophysiology, University Clinic Göttingen, Göttingen, Germany.
authors.forename: Thomas A
authors.initials: TA
authors.lastname: Crozier
mesh_terms: D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010812:Physical Stimulation / Q000379:methods; D011312:Pressure; D011601:Psychophysics; D012684:Sensory Thresholds / Q000502:physiology*; D012867:Skin / Q000294:innervation; D013823:Thermoreceptors / Q000502:physiology*